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Association Between the Publication of Clinical Evidence and the Use of Bariatric Surgery

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Abstract

Purpose

The purpose of this study was to assess whether publication of clinical evidence was associated with increased utilization of bariatric surgery.

Methods

We systematically searched the literature (1994 to 2008) to identify studies on bariatric surgery. We sorted the evidence by publication date and citation frequency. We linked the published evidence to data from the Kaiser Permanente Washington (KPWA) on 1421 bariatric surgery cases and 45,665 medically managed patients with severe obesity to assess the association between evidence and use of bariatric surgery. We used an interrupted time series analysis with a control group to estimate the association. In secondary analyses, we examined the association with accumulating major clinical evidence, the type of evidence, and stratification by influential tiers.

Results

A total of 9913 papers were identified and the top 100 cited papers were initially selected. After inclusion criteria were applied, 35 papers were selected. We selected the fourth quarter in 2004 as the exposure based on publication for the two studies with the largest number of citations. Compared to the projected secular trend, the publication of those two major articles was associated with 50 additional cases of bariatric surgery performed per 100,000 eligible individuals per quarter. In our secondary analyses, higher quality evidence (e.g., RCTs) and more highly cited evidence were each associated with a greater probability of receiving bariatric surgery.

Conclusions

For patient members of the KPWA with severe obesity, publication of clinical evidence was associated with increased use of bariatric surgery. This finding suggests that publication of higher quality positive clinical evidence may influence utilization.

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Authors and Affiliations

  1. Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St. Box 63, Boston, MA, 02111, USA

    David D. Kim

  2. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA

    David E. Arterburn

  3. Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, University of Washington, Seattle, WA, USA

    Sean D. Sullivan & Anirban Basu

  4. Department of Health Services and Economics, University of Washington, Seattle, WA, USA

    Anirban Basu

Authors
  1. David D. Kim
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  2. David E. Arterburn
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  4. Anirban Basu
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Correspondence to David D. Kim.

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Kim, D.D., Arterburn, D.E., Sullivan, S.D. et al. Association Between the Publication of Clinical Evidence and the Use of Bariatric Surgery. OBES SURG 28, 1321–1328 (2018). https://doi.org/10.1007/s11695-017-2990-1

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